Concussion

Definition

A concussion is an injury to your brain that causes problems with how the brain works. It can affect brain tasks like memory, balance, concentration, judgement, and coordination.

Most will have a full recovery but the brain will need time to heal with the proper rest and monitoring.

Causes

A concussion is caused by a sudden, violent jolt to the brain. The force can cause stretching and tearing to the brain and soft tissue that supports it. Forces that can cause this type of damage include:

Risk Factors

Participation in contact sports like football or boxing, especially during competition

Work that involves farming, logging, or construction where the potential for a head injury is high

Being in a car accident

Increased susceptibility to concussion

Alcohol intoxication

Concussions most often occur with:

Motor vehicles

Bicycles

Skates, skateboards, and scooters

Sports and recreation

Falls

Firearms

Physical violence including
domestic abuse or child abuse

Symptoms

A concussion can cause symptoms that may last for days, weeks, or even longer. They may be immediately present or appear a few hours or days after the injury. The symptoms that develop will depend on the severity of the injury. More common symptoms are listed below.

Physical symptoms may include:

Low-grade headache or neck pain

Loss of balance or coordination

Feeling lightheaded

Ringing in the ears or trouble hearing

Blurred vision or eyes that tire easily

Nausea or vomiting

Feeling fatigued or tired

Increased sensitivity to sounds, light, or distraction

Numbness

Change in sleeping pattern, sleeping more than normal or trouble sleeping

Seizures

Mental and emotional symptoms may include:

Confusion

Loss of consciousness or memory about the accident

Trouble processing information such as difficulty:

Remembering things

Paying attention or concentrating

Organizing daily tasks

Making decisions and solving problems

Slowness in thinking, acting, speaking, or reading

Mood instability or changes such as:

Feeling sad, anxious, or listless

Becoming easily irritated or angry for little or no reason

Lacking motivation

Hallucinations

A doctor should be consulted if serious symptoms like confusion and vomiting occur or if symptoms get worse.

Young children may not be able to clearly communicate symptoms. Talk to a doctor if the child has had a head injury and is showing any of the following symptoms:

Listlessness or tiring easily

Irritability or crankiness

Changes in:

Eating or sleeping patterns

Play

Behavior

School performance

Lack of interest in favorite toys or activities

Loss of new skills, such as toilet training

Loss of balance, unsteady walking

Diagnosis

You will be asked about your symptoms and how the injury occurred. Others who witnessed the accident may also be asked to describe what happened and how you reacted. A physical exam will be done. It will often include brief tests for strength, sensation, balance, reflexes, and memory. The doctor will often be able to diagnose a concussion based on the exam and history.

A CT scan may be done if there are severe symptoms or certain risk factors but are not always needed.

Treatment

The brain can often heal on its own with rest and avoiding activities that may be harmful while it heals. Symptoms will gradually fade during recovery.

Mental Rest

The brain will need full rest at first. This means adjusting physical activities and decreasing mentally-demanding tasks. Early in recovery, activities that need concentration like work or schoolwork will need to be avoided. For children this also includes avoiding video games, watching television, computer activities, or texting.

Mental and physical activities will gradually be added once initial symptoms improve. Symptoms, balance, cognition and tolerance to current activity levels will be tested throughout recovery. This information will be used to decide if further rest is needed or it is time to progress to the next step. Returning to mental or physical activities too quickly can make symptoms worse and slow the recovery process.

Prevent Further Damage

The brain is more vulnerable to injuries while it is healing. Re-injury can lead to more severe or long-term symptoms. Precautions should be taken with:

Activities that might jolt or jar the head from recreational activities ad sports to rollercoasters.

Second head injury can be especially dangerous in children and adolescents (second impact syndrome). Even a mild second head injury in children and adolescents can lead to serious damage to the brain. This can lead to unconsciousness and even death.

Prevention

A closed head injury is often the result of an accident which can be difficult to prevent. To decrease the chance of severe injuries during an accident:

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Halstead ME, Walter KD, Council on Sports Medicine and Fitness. American Academy of Pediatrics. Clinical report--sport-related concussion in children and adolescents. Pediatrics. 2010 Sep;126(3):597-615. full-text